Individual provider Active NPI

Kuzma Kovzun

  • Psychiatry Physician
  • Roseville, CA
National Provider Identifier
1235592718
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A21889 Issued in CA
Practice address
8775 Sierra College Blvd Ste 200
Roseville, CA 95661-5985
Phone
(448) 678-4448
NPI assigned
Apr 1, 2016
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X DOS1846 HI
Psychiatry Physician 2084P0800X 20A21889 CA Primary

Addresses

Primary practice location

8775 Sierra College Blvd Ste 200
Roseville, CA 95661-5985

Mailing address

8775 Sierra College Blvd Ste 200
Roseville, CA 95661-5985
Phone (844) 867-8444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240424002488 CA Practitioner - Psychiatry 7012216633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Arizona College of Osteopathic Medicine Mid Western University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

8775 Sierra College Blvd
Suite 200
Roseville, CA 95661-5985
Phone (916) 294-7062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DOS1846HIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Health Solutions a Professional Medical Corporation Psychiatry CurrentSince Apr 10, 2024 Accepting new patients

Locations

1020 Suncast Ln
Ste 108
El Dorado Hills, CA 95762
Phone (916) 932-0380

3300 Webster St
Ste 803
Oakland, CA 94609

1731 E Roseville Pkwy
Ste 290
Roseville, CA 95661
Phone (916) 262-9002

8775 Sierra College Blvd
Ste 200
Roseville, CA 95661
Phone (916) 294-7062

360 Post St
Ste 500
San Francisco, CA 94108
Phone (415) 213-2540

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1235592718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8775 SIERRA COLLEGE BLVD STE 200",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615985",
            "telephone_number": "844-867-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8775 SIERRA COLLEGE BLVD STE 200",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956615985",
            "telephone_number": "448-678-4448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVZUN",
        "first_name": "KUZMA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-01",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "DOS1846",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A21889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.